Exploring psychological resilience among pre-adolescents orphaned by AIDS: a case study

Abstract

English: Children maturing toward adulthood not only grow physically, but also develop psychologically and in ways that define intellectual, social, spiritual and emotional characteristics. The circumstances or conditions in which this growth takes place can impede or enhance their development. Presently, poor socio-economic circumstances in South Africa are fuelling the Human Immunodeficiency Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS) epidemic in the country, which is depriving families and communities of the assets and social structures necessary for the healthy development of children. In many instances, HIV/AIDS causes the very conditions that enable the epidemic to thrive. However, some children seem to cope, irrespective of these challenging conditions. They appear to rise above their circumstances and attain outcomes associated with healthy development. In other words, faced with significant stressors or adversity, these children display the ability to be resilient. With this in mind, research was conducted to identify and explore factors contributing to psychological resilience among children who lost their primary caregivers as a result of AIDS. The research focused on eight pre-adolescents living in a community care facility, Lebone Land in Bloemfontein. Primary data were obtained by means of individual interviews. Research tools that incorporate drawing were used to assist and structure the data collection process. Factors that enable the children to cope with and overcome adversities related to AIDS, as well as the actual adversities pertaining to each child, were identified and explored. In addition, individual semi-structured interviews were conducted with seven key informants involved with the education and care of these children in order to collect complementary data regarding the children's behaviour, prior residence and family characteristics, as well as future prospects. Data were anaylised using the constant comparative method. Results indicated that adversities such as illness, death, poverty and violence were significant among the children in the research group. Common factors that contributed to psychological resilience among the group mainly included morality, social values, resistance skills, religion and faith. These inner resources generally played an important role in assisting the children with their purpose in life. To this end, constructive use of time, commitment to learning, goal-setting, problem-solving ability and self-efficacy played a fundamental role in attaining their future projections. Therefore, the qualities of optimism, perseverance and hope characterised the children’s process of recovery. Strong relational networks of support, particularly friendships with other children from Lebone, also contributed toward developing and sustaining resilience. Based on these results, it is theorised that the causal conditions leading to psychological resilience include need deprivation with resulting tension, and that these elicit the use of defences, specifically repression as a means of coping with traumatic incidents or adversity. As far as the latter is concerned, psychological resilience entails the constant resolution and mediation of the past, present and future. This process necessitates the development of self-awareness not only to facilitate access to external and internal resources, but also to effectively deal with pain associated with loss. The key determining factor or relational condition thought to influence this process is love. In addition, it is posited that by way of cognitive reframing or “re-authoring” and the configuration of a strong internal locus of control (belief system), children may overcome adversity and lead constructive lives. The results of this study suggest that programmes aimed at promoting resilience in AIDS orphans should employ a Gestalt therapy approach and incorporate creative and expressive activities. Outcomes of such initiatives should preferably be demonstrated by means of longitudinal research strategies.

Afrikaans: Met volwassewording groei kinders nie net fisies nie, maar ontwikkel ook psigies en op wyses wat intellektuele, sosiale, geestelike en emosionele eienskappe definieer. Die omstandighede of toestande waarin hierdie groei plaasvind kan hul ontwikkeling strem of bevorder. Swak sosio-ekonomiese omstandighede in Suid-Afrika versnel tans die Menslike Immuungebrekvirus (MIV) en die Verworwe Immuungebreksindroom (VIGS) epidemie wat gesinne en gemeenskappe van die nodige bates en sosiale strukture vir die gesonde ontwikkeling van kinders ontneem. In baie gevalle veroorsaak MIV/VIGS juis die toestande wat die epidemie laat toeneem. Sommige kinders toon egter die vermoë om hierdie uitdagende toestande te kan hanteer. Dit blyk dat hulle bo hul omstandighede uitstyg en uitkomste wat met gesonde ontwikkeling verband hou, bereik. Met ander woorde, gegewe die stressors of teenslae wat hierdie kinders in die gesig staar, toon hulle psigologiese weerbaarheid. Op grond van die voorafgaande is navorsing onderneem om die faktore wat tot psigologiese weerbaarheid by VIGS-wese mag lei te identifiseer en te ondersoek. Primêre data is deur middel van individuele onderhoude met agt preadolessente van ʼn gemeenskapversorgingsfasiliteit, Lebone Land in Bloemfontein, verkry. Navorsingsinstrumente wat teken as aktiwiteit insluit is as hulpmiddel gebruik om die dataversamelingsproses te struktureer. Faktore wat kinders in staat stel om teenslae wat met VIGS verband hou te hanteer en die hoof te bied, asook spesifieke teenslae ten opsigte van elke kind, is geïdentifiseer en ondersoek. Bykomend is individuele semi-gestruktureerde onderhoude met sewe sleutelpersone gehou wat by die onderrig en versorging van hierdie kinders betrokke is. Tydens hierdie onderhoude is aanvullende data aangaande die kinders se gedrag, vroeëre verblyf- en gesinseienskappe, en toekomsverwagtinge ingesamel. Data is deur middel van die konstante vergelykende metode geanaliseer. Die resultate toon dat veral teenslae soos siekte, dood, armoede en geweld onder die kinders in die navorsingsgroep voorgekom het. Algemene faktore wat tot psigologiese weerbaarheid gelei het, het hoofsaaklik moraliteit, sosiale waardes, weerstandsvaardighede, asook godsdiens en geloof ingesluit. Hierdie innerlike hulpbronne het ʼn belangrike bydrae tot die verwesenliking van hul lewensdoelstellings gelewer. Ten opsigte hiervan het konstruktiewe tydgebruik, verbintenis tot leer, doelwitstelling, probleemoplossingsvaardighede en selfeffektiwiteit ʼn fundamentele rol gespeel ten einde hul toekomsprojeksies te bereik. Optimisme, deursettingsvermoë en hoop het die kinders se herstelproses gekenmerk. Sterk ondersteuningsnetwerke, veral vriendskappe met ander kinders van Lebone, het ook tot die ontwikkeling en volhoubaarheid van weerbaarheid bygedra. Op grond van hierdie resultate word geredeneer dat die toestande wat tot psigologiese weerbaarheid lei, behoefte deprivasie en gevolglike spanning behels wat verdedigingsmeganismes ontlok, spesifiek repressie as metode om traumatiese insidente of teenslae te hanteer. In hierdie verband bestaan psigologiese weerbaarheid uit die konstante bemiddeling en oplossing van aspekte rakende die verlede, hede en toekoms. Dié proses noodsaak nie net die ontwikkeling van gesonde selfbewussyn om toegang tot eksterne en interne hulpbronne te fasiliteer nie, maar ook om pyn wat met verlies verband hou effektief te hanteer. Die sleutelfaktor of verhoudingsvoorwaarde wat hierdie proses beïnvloed blyk liefde te wees. Bykomend word aangevoer dat kinders deur middel van kognitiewe herstrukturering of “herskrywing”, asook die strukturering van ‘n sterk interne lokus van beheer (oortuigings), teenslae kan oorkom en ʼn konstruktiewe lewe kan lei. Die resultate van hierdie studie dui daarop dat programme wat die bevordering van weerbaarheid by VIGSwese ten doel stel, ‘n gestaltterapie-benadering moet volg en kreatiewe en ekspressiewe aktiwiteite insluit. Die uitkomste van sulke inisiatiewe moet verkieslik deur longitudinale navorsingstrategieë aangedui word.